目的:为了检验以下假设,即口服摄入到达回肠的缓慢消化的碳水化合物(SDCs)会触发回肠制动,如胃排空延迟所示,降低血糖反应,主观食欲下降。
方法:这项研究是一个五臂,随机化,双盲,交叉试验,治疗之间有1周的洗脱期(n=20;9名女性,11名男性)。五种处理由三种SDC成分组成[生玉米淀粉,低聚异麦芽糖(IMO),sucromalt],和IMO/sucromalt组合,在体外显示出缓慢和延长的消化曲线,和可快速消化的碳水化合物对照(麦芽糊精)。将碳水化合物(26克)掺入酸奶中[总共300克;碳水化合物(约77克),脂肪(~0.2克),和蛋白质(〜9g)]具有紧密匹配的能量含量(346kcal)和粘度(〜30,000cP)。结果在餐后4小时内测量。
结果:对于生玉米淀粉和IMO处理,平均胃半排空时间虽然显著增加,但适度(P<0.05)。但它们可以细分为较大效应应答者(n=11)和非应答者组(n=9)。在排除胃半排空时间>3.5h的探索性数据子集中,血糖反应恢复到基线的时间延长与胃半排空时间增加相关(P=0.02)。没有观察到食欲等级的显著差异。
结论:SDC通过激活回肠制动导致胃排空速度减慢,使用紧密匹配的半固体酸奶,只有碳水化合物消化速率不同。通过消耗SDC延长血糖反应与触发回肠制动有关。
背景:ClinicalTrials.govNCT03630445,2018年8月,回顾性注册。
OBJECTIVE: To test the hypothesis that oral ingestion of slowly digestible carbohydrates (SDCs) that reach the ileum triggers the ileal brake as indicated by delayed gastric emptying, reduced glycemic response, and decreased subjective appetite.
METHODS: The study was a five-arm, randomized, double-blind, crossover trial with a 1-week washout period between treatments (n = 20; 9 females, 11 males). Five treatments consisted of three SDC ingredients [raw corn starch, isomaltooligosaccharide (IMO), sucromalt], and an IMO/sucromalt combination, shown in vitro to have slow and extended digestion profiles, and a rapidly digestible carbohydrate control (maltodextrin). Carbohydrates (26 g) were incorporated into yogurt [300 g total; carbohydrate (~ 77 g), fat (~ 0.2 g), and protein (~ 9 g)] with closely matched energy content (346 kcal) and viscosity (~ 30,000 cP). Outcomes were measured in a 4 h postprandial period.
RESULTS: Mean gastric half-emptying times were moderately though significantly increased for the raw corn starch and IMO treatments (P < 0.05), but they could be sub-divided into larger effect responder (n = 11) and non-responder groups (n = 9). Longer time for glycemic response to return to baseline was associated with increased gastric half-emptying time in an exploratory subset of data removing gastric half-emptying times > 3.5 h (P = 0.02). No significant differences in appetite ratings were observed.
CONCLUSIONS: SDCs caused slower gastric emptying rate through activation of the ileal brake, as closely matched semi-solid yogurts were used and only rate of carbohydrate digestion differed. Extending glycemic response through consumption of SDCs was associated with triggering the ileal brake.
BACKGROUND: ClinicalTrials.gov NCT03630445, August 2018, retrospectively registered.